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Andreasen JJ, Tobiasen BB, Jensen RC, Boye H, Jensen TK, Bilenberg N, Andersen MS, Glintborg D. Maternal cortisol in 3rd trimester is associated with traits of neurodevelopmental disorder in offspring. Odense Child Cohort. Psychoneuroendocrinology 2023; 154:106293. [PMID: 37207405 DOI: 10.1016/j.psyneuen.2023.106293] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 05/12/2023] [Accepted: 05/13/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Prenatal cortisol exposure is essential for neurodevelopment. Maternal cortisol levels could be associated with offspring autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). AIM To investigate associations between maternal 3rd trimester cortisol and offspring traits of ASD and ADHD. MATERIAL AND METHODS Mother-child pairs were included from the prospective study Odense Child Cohort. Morning serum cortisol and 24-hour urine cortisol/cortisone were collected at gestational week 27-30. Offspring ASD and ADHD traits were assessed at age three and five years using the Child Behavior Checklist. Maternal cortisol measurements and offspring ASD and ADHD traits assessment were available in (n = 1131; 52% boys) mother-child pairs at age three and (n = 717; 54% boys) at five years of age. Maternal 24-hour urine measurement was available in a subset, at offspring three years of age (n = 300) and at five years of age (n = 217). Associations between maternal cortisol (continuous and tertiles) and offspring ASD or ADHD traits were examined in regression models adjusted for offspring sex, maternal age, pre-pregnancy BMI, parity, maternal education level, parental psychiatric disorders, and maternal smoking and stratified for offspring sex. RESULTS Maternal mean age ( ± SD) was 30 years ( ± 4.4) and median BMI (25%; 75% percentiles) 23.5 kg/m2 (21.3; 26.6). Higher maternal serum cortisol levels were associated with higher prevalence of offspring ASD traits at three years of age in the total study cohort and in boys after stratifying for offspring sex. In the total population, tertiles of serum cortisol showed a significant dose-response relationship to ASD traits in unadjusted and adjusted models (p-values for linear trend, p < 0.01 and p = 0.02, respectively). In offspring at five years, associations between maternal cortisol and offspring ASD traits were non-significant (all p-values > 0.2). Maternal cortisol was not associated with offspring ADHD traits (all p-values > 0.07) in offspring at three and five years. Maternal 24-hour urine cortisol, cortisone, or cortisol/cortisone ratio were not associated with offspring ASD or ADHD traits. CONCLUSION Higher maternal serum cortisol in 3rd trimester was associated with offspring ASD traits at three years of age in the whole study cohort and in boys, but not in girls. This association was non-significant at five years of age.
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Affiliation(s)
- Jonas Jannick Andreasen
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Bror Bastian Tobiasen
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Richard Christian Jensen
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark; Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Odense University Hospital, Odense C, Denmark; Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Henriette Boye
- Odense Child Cohort, Hans Christian Andersen Hospital for Children, Odense University Hospital, Denmark; OPEN Patient data Explorative Network (OPEN), University of Southern Denmark, Denmark
| | - Tina Kold Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Odense University Hospital, Odense C, Denmark; Odense Child Cohort, Hans Christian Andersen Hospital for Children, Odense University Hospital, Denmark; OPEN Patient data Explorative Network (OPEN), University of Southern Denmark, Denmark
| | - Niels Bilenberg
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Marianne Skovsager Andersen
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Dorte Glintborg
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
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Al-Jorani H, Jensen RC, Jonasson MTE, Birukov A, Schmedes AV, Christesen HT, Dreyer AF, Jensen TK, Glintborg D, Jensen BL, Andersen MS. Higher Maternal Cortisol Associated With Lower Blood Pressure in Offspring From 3 Months to 5 Years of Age in the Odense Child Cohort. Hypertension 2023; 80:828-836. [PMID: 36802792 DOI: 10.1161/hypertensionaha.122.20265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Synthetic glucocorticoid exposure in late pregnancy may be associated with higher blood pressure in offspring. We hypothesized that endogenous cortisol in pregnancy relates to offspring blood pressure (OBP). OBJECTIVE To investigate associations between maternal cortisol status in third trimester pregnancy and OBP. METHODS We included 1317 mother-child pairs from Odense Child Cohort, an observational prospective cohort. Serum (s-) cortisol and 24-hour urine (u-) cortisol and cortisone were assessed in gestational week 28. Offspring systolic blood pressure and diastolic blood pressure were measured at age 3, 18 months, and 3 and 5 years. Associations between maternal cortisol and OBP were examined by mixed effects linear models. RESULTS All significant associations between maternal cortisol and OBP were negative. In boys in pooled analyses, 1 nmol/L increase in maternal s-cortisol was associated with average decrease in systolic blood pressure (β=-0.003 mmHg [95% CI, -0.005 to -0.0003]) and diastolic blood pressure (β=-0.002 mmHg [95% CI, -0.004 to -0.0004]) after adjusting for confounders. At 3 months of age, higher maternal s-cortisol was significantly associated with lower systolic blood pressure (β=-0.01 mmHg [95% CI, -0.01 to -0.004]) and diastolic blood pressure (β=-0.010 mmHg [95% CI, -0.012 to -0.011]) in boys after adjusting for confounders, which remained significant after adjusting for potential intermediate factors. CONCLUSIONS We found temporal sex dimorphic negative associations between maternal s-cortisol levels and OBP, with significant findings in boys. We conclude that physiological maternal cortisol is not a risk factor for higher blood pressure in offspring up to 5 years of age.
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Affiliation(s)
- Hajir Al-Jorani
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.)
| | - Richard Christian Jensen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.).,Department of Clinical Pharmacology, Pharmacy and Environmental Medicine (R.C.J., T.K.J.), University of Southern Denmark, Odense, Denmark
| | - Mikaela T E Jonasson
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.)
| | - Anna Birukov
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany (A.B.)
| | - Anne Vibeke Schmedes
- Department of Biochemistry and Immunology, Lillebaelt Hospital, Vejle, Denmark (A.V.S.)
| | - Henrik Thybo Christesen
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.T.C., T.K.J.)
| | - Anja F Dreyer
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.)
| | - Tina K Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine (R.C.J., T.K.J.), University of Southern Denmark, Odense, Denmark.,Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.T.C., T.K.J.)
| | - Dorte Glintborg
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.)
| | - Boye L Jensen
- Institute for Molecular Medicine (B.L.J.), University of Southern Denmark, Odense, Denmark
| | - Marianne S Andersen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.)
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8
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Birukov A, Herse F, Nielsen JH, Kyhl HB, Golic M, Kräker K, Haase N, Busjahn A, Bruun S, Jensen BL, Müller DN, Jensen TK, Christesen HT, Andersen MS, Jørgensen JS, Dechend R, Andersen LB. Blood Pressure and Angiogenic Markers in Pregnancy: Contributors to Pregnancy-Induced Hypertension and Offspring Cardiovascular Risk. Hypertension 2020; 76:901-909. [PMID: 32507044 DOI: 10.1161/hypertensionaha.119.13966] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Pregnancy-induced hypertension is a severe pregnancy complication, increasing risk of long-term cardiovascular disease in mothers and offspring. We hypothesized that maternal blood pressure in pregnancy associated with offspring blood pressure; that the associations were sex-specific; and that maternal circulating placental angiogenic markers (PlGF [placental growth factor] and sFlt-1 [soluble fms-like tyrosine kinase-1]) mediated this relationship. We analyzed data from 2434 women and 2217 children from the Odense Child Cohort, a prospective Danish cohort study. Offspring blood pressure trajectory from 4 months to 5 years was highly associated to maternal first, second, and third trimester blood pressure, and mean blood pressure in pregnancy, independent of maternal and offspring covariates. There were offspring sex-specific associations: Girls from mothers in the highest quartile of first and third trimester blood pressure had significantly higher systolic blood pressure at 5 years than the rest of the cohort (mean difference±SEM: 1.81±0.59 and 2.11±0.59 mm Hg, respectively, all P<0.01); whereas boys had significantly higher diastolic blood pressure at 5 years (mean difference±SEM: 1.11±0.45 and 1.03±0.45, respectively, all P<0.05). Concentrations of PlGF at gestational week 28 correlated inversely to maternal gestational blood pressure trajectory, independent of the diagnosis of pregnancy-induced hypertension, adjusted β coefficients (95% CI) for predicting systolic blood pressure (SBP): -3.18 (-4.66 to -1.70) mm Hg, for predicting diastolic blood pressure (DBP): -2.48 (-3.57 to -1.40) mm Hg. In conclusion, maternal gestational blood pressure predicted offspring blood pressure trajectory until 5 years in a sex-differential manner. Furthermore, subtle alterations in blood pressure in early pregnancy preceded hypertension or preeclampsia, and PlGF was a mediator of cardiovascular health in pregnancy.
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Affiliation(s)
- Anna Birukov
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark (A. Birukov, J.S.J., L.B.A.).,Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany (A. Birukov)
| | - Florian Herse
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Julie H Nielsen
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark (J.H.N., M.S.A.)
| | - Henriette B Kyhl
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.)
| | - Michaela Golic
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Kristin Kräker
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Nadine Haase
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | | | - Signe Bruun
- OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.).,Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (S.B., H.T.C.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.).,Strategic Business Unit Pediatric, Arla Foods Ingredients Group P/S, Viby J, Denmark (S.B.)
| | - Boye L Jensen
- Institute for Molecular Medicine, University of Southern Denmark, Odense, Denmark (B.L.J.)
| | - Dominik N Müller
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Tina Kold Jensen
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark (T.K.J.)
| | - Henrik T Christesen
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.).,Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (S.B., H.T.C.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.)
| | | | - Jan Stener Jørgensen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark (A. Birukov, J.S.J., L.B.A.).,Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.)
| | - Ralf Dechend
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.).,Department of Cardiology and Nephrology, HELIOS-Klinikum, Berlin, Germany (R.D.)
| | - Louise Bjørkholt Andersen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark (A. Birukov, J.S.J., L.B.A.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.).,Department of Obstetrics and Gynecology, Herlev Hospital, Denmark (L.B.A.)
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